Community response test for circumcision for HIV prevention

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Community response test for circumcision

OUR SPECIAL CORRESPONDENT

New Delhi, Jan. 1: A task force of the Indian Council of Medical

Research has proposed a study to determine levels of community

comfort with male circumcision, a possible method to prevent the

spread of HIV.

Keeping in view possible impacts that culture and religion might have

on attitudes to male circumcision, the task force has suggested a

multi-site study to understand community perceptions about the

practice.

Clinical trials in Africa have shown that circumcision of male adults

can reduce the risk of picking up HIV during heterosexual activity by

60 per cent. The protective effect was so strong that a data safety

monitoring board stopped the studies and recommended that

circumcision should be offered as an option to all participants of

the trials.

ICMR officials said the task force was set up to identify priority

areas for research in the field of male circumcision relevant to

India.

" We have virtually no data about current practices, facilities

available, or the rate of complications in male circumcision in

India, " said Nomita Chandiok, the deputy director-general of the ICMR.

" Community perceptions are crucial in determining acceptability. But

all we know about male circumcision in India is based on hearsay and

assumptions. We need studies to understand the ground situation, " she

said.

How exactly circumcision protects against HIV infection is still

unclear, but scientists believe that the male foreskin contains a

concentration of cells that serve as gateways for the virus to enter

the human body in the earliest stages of HIV infection.

Previous research studies have shown that circumcision lowers rates

of urinary tract infections in infants and also lowers the prevalence

of genital ulcer diseases which are a risk factor for picking up HIV.

A global consultation by the World Health Organisation and the UNAIDS

earlier this year had said that for countries such as India, where

HIV is largely concentrated in specific population groups, there

would be little public health benefit in promoting male circumcision

in the general population.

" This is a sensitive issue. Individuals at high risk of HIV may

benefit from it, but only a study on community perceptions will help

us determine whether it would be acceptable as a preventive method

here, " a community medicine specialist said.

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